Monday, 28 November 2016

When Childbirth Puts Woman’s Life In Danger

“I came here because my bladder busted when I went to deliver my baby
many years ago and since then my health condition has not remain the
same due to pains and discomfort l go through on a daily basis.”

These were the words of Lucia Ofoegbu, 63, from Anambra State. Lucia
is among the women who were recently treated of Vesico Vagina Fistula
(VVF ) at the National Obstetrics Fistula hospital Abakaliki, Ebonyi State.

Lucia said she was thrown out of her matrimonial home, because she came
down with VVF, 50 years ago, following a ruptured bladder. In this
story which will bring tears to most eyes, Lucia in an emotion-laden
voice, which contrasts with the joy she now feels, told a team of health
reporters on a facility visit to the hospital, the first National VVF
hospital in the country, that the condition took away her pride.

The facility visit was part of a three-day training for health
reporters, sponsored by Engender health, an international
non-governmental organization implementing a USAID funded Fistula care
project in Nigeria.
According to Lucia: "It happened 50 years ago and I was managing it
throughout the period, because I did not know where to go to. I was
pregnant of twins – two boys. I laboured for three days, before they
took me to Okwuzuuzor, Anambra state. After everything, I lost both
babies and came down with Fistula.”

Health workers describe Obstetric Fistula or VVF as a medical condition
in which a fistula – hole develops between either the rectum or vagina. When the link is between the rectum and the bladder, it
called is Recto Vagina Fistula (RVF). They say either of these
conditions are caused by obstructed prolonged labour due to childbirth.
Medical workers say this is pronounced in situation where access to
adequate medical care is not available.

While Lucia’s VVF case appears to be like one of the consequences of
early marriage and prolonged labour, there are other examples in the
centre at Abakiliki which are problems of having too many children.

Dr. Suleiman Zakariya, Clinical Associate, Fistula Care plus, says that
a labour can be described to be prolonged when it is beyond eight
hours. Research has shown that when women have too many children over a
short period of time they are exposed to life threatening complications
such as fistula during delivery. Zakariya also notes that women who adopted any of the various Family
Planning (FP) methods can have as many children as they want with
minimal risk.

If only Lucia had known, as she told her story, she could not hold back
her tears. Her sullen eyes captured her regrets not knowing of any
Family Planning method earlier. None of her interviewers could control
their emotions as Lucia recounted her pains following rejection and
humiliation from her husband and in-laws. She said: “A year after, my
husband went to the city and came back with another woman and they have
been treating me so badly. They threw me out of the house,” she said
amidst sobs. Regretting the condition , she says it left her childless without any husband.
“Succour only came when my relatives came to my husband’s house and took me back to my father’s house for rehabilitation.”

Zakariya says some major elements of fistula damage is urinary or
faecal incontinence. In addition to these physical problems, VVF and
RVF cause acute social problems studies have shown. Due to constant
leaking of urine or faeces and the accompanying smell, many communities
consider these women outcasts and cut them off from all social
activities. Commuting in public transport and engaging in social
activities such as weddings and naming ceremonies becomes difficult.

Zakariya says: “If the fistulae are not repaired, their husbands may
divorce the women. Some leave their families to roam in the cities
where they are not known as the outlook for them remain bleak in the
community.” Lucia fits into this gloomy picture. It took the intervention of a Catholic Priest for Lucia to access care
and treatment at the National Obstetric fistula centre, Abakiliki, where
her dignity has been restored by well-trained surgeons with
specialization in fistula repair.

Talking of the priest who directed her to the hospital, Lucia said: “The
person that brought me here was a priest. He noticed me because I
normally don’t come close to where others are. On one occasion, he
called me and said what was the problem and after I narrated my story
he was the one that brought me to this place. Now I have been discharged
today. I am actually waiting for the Priest to come and take me back. She said since coming down with fisula, the priest is one of the few
people she can identify as a relative. “Even all these period I have
been here, my husband never asked of me and my co-wife never asked of
me. It has been hell for me all these years.”

Lucia story is just one out of the millions of the estimated 150,000
million Nigeria women who for one reason or the other are suffering the
condition called, fistula. The health condition has been identified by
experts as a silent killer of millions of women of reproductive age
worldwide.
In Nigeria, health experts say fistula is now a major public health
condition responsible for the growing numbers of maternal and child
mortality, morbidity as well as neonatal death rates.
The centre at Abakiliki, is one of the 13 fistula centres in the country
supported by Fistula Care Plus established in 2010, to address the
issue which experts describe as a public health crisis.

Dr. Kennneth Ekwedike, Chairman, Medical Advisory Council of the
hospital, who was represented by Dr. Yakubu Emmanuel, a Consultant
Gyneacologist, describes obstetric fistula as one of the various
challenges women face in the process of child birth.
Dr. Emmanuel attributed the growing incidence of fistula in the country
to poverty. The next is ignorance, he said, adding that the condition
is prevalent among women who have many children over a short period of
time.

Commenting on the services of the centre, he notes that over 40 cases
of fistula clients have been repaired in the first quarter of the year,
which shows a reduction in the number of cases repaired by the same time
last year, which is not an indication of decrease in the national
average. Jumoke Adekogba, a reproductive health and FP advisor with Engender
health also agrees that when women have too many children over a short
period of time they are exposed to life threatening complications.
Corroborating earlier views, she said: “With family planning women can
have as many children as they want without the risks of VVF.”
Also in agreement with this view is, Veronica Nwaoefe, Matron at the
Abakaliki Centre, submits that family planning shares a link with
fistula, noting that it is a preventive measure against VVF. To
her, family planning also helps women who are successfully treated to
wait for a while so that they will heal and totally recuperate before
planning for another pregnancy.

“When children are properly spaced it ensures the health of the mother
and child thereby reducing fistula as a rare event for future
generations, ”Nwaoefe adds.
Nigeria has a backlog of between 120,000 to 150,000 fistula cases with
an increase of 12,000 new cases occurring annually, according to Fistula
Care Plus. However, the numbers of fistula facilities in the country
are very few. The project also says the number of qualified doctors who
can professionally repair fistula clients are about only 23 with 174
nurses to man the facilities.

The project therefore, stresses the need for government, the private
sector and donors to act together and stop the condition by encouraging
family spacing, regular antenatal care and hospital deliveries.

Mrs. Chioma Adanma Umeha is a journalist of over two decades experience. At the moment, she is the Health Editor of Newswatch Times, Lagos, Nigeria.
A graduate of Mass Communications from Anambra State University, Enugu, she also holds a Masters Degree in International Relations and Strategic Studies from the Lagos State University, Ojo, Lagos.

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About Me

Mrs. Chioma Adanma Umeha is a journalist of over two decades experience. At the moment, she is the Health Editor of Newswatch Times, Lagos, Nigeria.
A graduate of Mass Communications from Anambra State University, Enugu, she also holds a Masters Degree in International Relations and Strategic Studies from the Lagos State University, Ojo, Lagos.